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$� City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Return form to the Clerk of the Council Office (M -30). <br />Call 647 -1520 if you have any questions. <br />The agreement with R.B. Welding, Inc. <br />COTC <br />JAN 20 M4 37 15 <br />(1 ;t ('' `i'NA <br />ER K 6` <br />G al✓ <br />No. N -2011 -058 was completed on 6/30/2012 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: PWA -Water <br />Phone /Ext.: 3379 <br />Signature: <br />C / <br />Date: 1/20/2016 <br />Revised 10.31 -12 <br />